Uptake of paediatric surgical interventions in the face of catastrophic health expenditure and a declining global economy
7 affiliations
- 1Division of Paediatric Unit, Department of Surgery, Faculty of Clinical Sciences, University of Ilorin and University of Ilorin Teaching Hospital, Ilorin, Nigeria
- 2Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
- 3MCON Research Institute, Lagos, Nigeria
- 4Department of anesthesia, University of Ilorin Teaching Hospital, Ilorin, Nigeria
- 5College of Health Sciences, University of Ilorin, Ilorin, Nigeria
- 6National Institute of Health and Care Research, Global Surgery Unit, Nigeria Hub, College of Medicine, University of Lagos, Lagos, Nigeria
- 7Paediatric Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
Abstract
Background: Out-of-pocket payment for surgical care exposes many households in low- and middle-income countries to catastrophic health expenditure. Children requiring common elective surgical intervention may therefore experience substantial delay in accessing treatment as a result of this. This study assesses the risk of catastrophic health expenditure, and factors associated with delayed surgical intervention in children among families attending a free pediatric surgical outreach programme.
Methods: A cross-sectional study was conducted among caregivers of children who received free surgery during a free surgical outreach. Information on household income, food expenditure, prior healthcare financing, and previous delays to treatment were obtained using interviewer-administered questionnaires. Catastrophic health expenditure was defined as health expenditure exceeding 10% of total annual household income, and descriptive statistical analysis done.
Results: A total of 151 respondents were analyzed. Herniotomy accounted for 91.3% of procedures. The mean age at presentation was 6.63 years. Delay in obtaining surgery was reported by 63.6% of caregivers, with financial constraint being the most frequent reason. Most households relied on out-of-pocket payments (81.6%), while insurance utilization was limited. If out-of-pocket payment had been required, 60.3% of families may have been at risk of exceeding the catastrophic health expenditure threshold.
Conclusion: This study demonstrates financial vulnerability among families seeking paediatric surgical care, characterized by low level of healthcare insurance coverage and utilization, with continued reliance on out-of-pocket healthcare payments. Findings from this study highlight the important role of free surgical outreach programmes in reducing unmet surgical needs and mitigating the immediate financial burden associated with paediatric surgical care. However sustainable long-term solutions will require expansion of effective health insurance coverage, strengthening of referral systems, and improving the availability of pediatric surgical services especially in underserved areas.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15280-w.
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BibTeX
@article{abdurrahman2026uptake,
title = {{Uptake of paediatric surgical interventions in the face of catastrophic health expenditure and a declining global economy}},
author = {Lukman O. Abdur-Rahman and Abdulwahab Lawal and Nurudeen Abdulraheem and Abdulrasheed Nasir and Kazeem Adegboye and Abdulrasaq Jimoh and Olayinka Sayomi and Tolulope Abe and Nasiru Jimoh and Olawunmi Adenuga and Chijindu Chijoke and Mahmud Ahmed and Ahmad Buhari and Sodiq Adeoti and Abdulmalik Adeyemo and Hussein Bello and Babs-Lawal Muhibat and Suliyat Ademola and Zainab Buhari and Adesoji Ademuyiwa and James Adeniran},
journal = {BMC Health Services Research},
year = {2026},
month = aug,
doi = {10.1186/s12913-026-15280-w},
url = {https://doi.org/10.1186/s12913-026-15280-w},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Uptake of paediatric surgical interventions in the face of catastrophic health expenditure and a declining global economy
AU - Lukman O. Abdur-Rahman
AU - Abdulwahab Lawal
AU - Nurudeen Abdulraheem
AU - Abdulrasheed Nasir
AU - Kazeem Adegboye
AU - Abdulrasaq Jimoh
AU - Olayinka Sayomi
AU - Tolulope Abe
AU - Nasiru Jimoh
AU - Olawunmi Adenuga
AU - Chijindu Chijoke
AU - Mahmud Ahmed
AU - Ahmad Buhari
AU - Sodiq Adeoti
AU - Abdulmalik Adeyemo
AU - Hussein Bello
AU - Babs-Lawal Muhibat
AU - Suliyat Ademola
AU - Zainab Buhari
AU - Adesoji Ademuyiwa
AU - James Adeniran
PY - 2026
DA - 2026/08/07
JO - BMC Health Services Research
DO - 10.1186/s12913-026-15280-w
UR - https://doi.org/10.1186/s12913-026-15280-w
AB - Background: Out-of-pocket payment for surgical care exposes many households in low- and middle-income countries to catastrophic health expenditure. Children requiring common elective surgical intervention may therefore experience substantial delay in accessing treatment as a result of this. This study assesses the risk of catastrophic health expenditure, and factors associated with delayed surgical intervention in children among families attending a free pediatric surgical outreach programme. Methods: A cross-sectional study was conducted among caregivers of children who received free surgery during a free surgical outreach. Information on household income, food expenditure, prior healthcare financing, and previous delays to treatment were obtained using interviewer-administered questionnaires. Catastrophic health expenditure was defined as health expenditure exceeding 10% of total annual household income, and descriptive statistical analysis done. Results: A total of 151 respondents were analyzed. Herniotomy accounted for 91.3% of procedures. The mean age at presentation was 6.63 years. Delay in obtaining surgery was reported by 63.6% of caregivers, with financial constraint being the most frequent reason. Most households relied on out-of-pocket payments (81.6%), while insurance utilization was limited. If out-of-pocket payment had been required, 60.3% of families may have been at risk of exceeding the catastrophic health expenditure threshold. Conclusion: This study demonstrates financial vulnerability among families seeking paediatric surgical care, characterized by low level of healthcare insurance coverage and utilization, with continued reliance on out-of-pocket healthcare payments. Findings from this study highlight the important role of free surgical outreach programmes in reducing unmet surgical needs and mitigating the immediate financial burden associated with paediatric surgical care. However sustainable long-term solutions will require expansion of effective health insurance coverage, strengthening of referral systems, and improving the availability of pediatric surgical services especially in underserved areas. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12913-026-15280-w.
SN - 1472-6963
ER -